Higher cigarette prices could help millions

A substantial increase in cigarette prices could help millions of people around the world avoid poor health and extreme poverty, according to research published by the BMJ. The findings show that people on low incomes have the most to gain. Researchers from the Global Tobacco Economics Consortium and the University of Toronto set out to predict the effect of a 50% increase in cigarette prices on health, poverty and financial protection in 13 middle-income countries, with a total of 500 million male smokers. The authors used a simple compartmental model, developed by the Disease Control Priorities Project and building on an earlier poverty and tobacco taxation analysis by the Asian Development Bank, to measure the impact of quitting, by age and income group, on life years gained, treatment costs averted, avoiding catastrophic medical costs and poverty, and additional tax revenue. Prices were assumed to have been raised by increasing tobacco excise taxes to reach the target price in each country. They found that a 50% price increase would lead to about 450 million years of life gained from quitting across the 13 countries, with half of these in China. Across all countries, men in the bottom income group (poorest 20% of the population) would gain seven times more life years than men in the top income group (richest 20% of the population; 155 v 23 million life years). The average number of life years gained from quitting for smokers in the bottom income group was five times that of those in the top group (1.46 v 0.23 life years). Of the $157 billion in averted treatment costs, the bottom income group would avert almost five times more than the top income group ($46 billion v $10 billion). In seven countries without universal health coverage, about 15.5 million men would avoid catastrophic medical costs. As a result, 8.8 million men, half of them in the bottom income group, would avoid falling below the World Bank definition of extreme poverty. Overall, 31% of the life years saved and 29% each of the averted disease costs and averted medical costs would be in the bottom income group while this group would contribute only 10% of the additional $122 billion taxes collected.

Mental disorders leading cause of illness in children globally

Researchers from the Université Paris-Saclay in France have found that, while global rates of mental disorders in children have remained stable over time, the decline of infectious diseases will place mental disorders among the main causes of disease in children aged 4–15 years. The study, published in Child and Adolescent Psychiatry and Mental Health, described the prevalence of mental disorders among children aged 5–14 years in each of the six regions of the World Health Organization – Africa, the Americas, South-East Asia, Europe, the East Mediterranean and the West Pacific Region. They found that even in emerging regions, the prevalence of mental disorders was high and constant over time. In 2000 in the Americas and Europe, mental disorders ranked third among the causes of disability-adjusted life-years (DALYs) – lost years of healthy life due to disease or disability. By 2015, mental disorders had reached second place as causes of DALYs in the Americas and Europe, while the impact of infectious diseases decreased. The change from infectious diseases to mental disorders as the main cause of DALYs in children is called an epidemiological transition. The impact of mental disorders on child health is going to become more important in the future as more countries make the transition from infectious diseases to mental disorders as major causes of ill health, according to the authors. In most regions, four mental disorders ranked among the 20 diseases associated with the most DALYs: conduct disorders, anxiety disorders, major depressive disorders and autism-Asperger syndrome. Among boys, the most common mental disorders associated with DALYs were conduct disorders, autism-Asperger syndrome and anxiety disorders. Among girls they were anxiety disorders, conduct disorders and major depressive disorder. In addition to an effect over time, the authors also noticed an effect of income: regions with the highest gross domestic product were found to have fewer problems with infectious diseases and more problems with mental disorders.

Online first at the MJA

16 April Perspective: Tackling the worsening epidemic of Buruli ulcer in Australia in an information void: time for an urgent scientific response
O’Brien et al; doi: 10.5694/mja17.00879
Understanding risk factors is key to defining the source and transmission route of Mycobacterium ulceransOPEN ACCESS until 23 April

16 April Medical education: A severe case of Mycobacterium ulcerans (Buruli ulcer) osteomyelitis requiring a below-knee amputation
Loftus et al; doi: 10.5694/mja17.01158
In July 2012, a 68-year-old man presented to his general practitioner in Brisbane with a swollen and painful right ankle … OPEN ACCESS until 23 April

16 April Editorial: Pollution, climate change, and childhood asthma in Australia
Sly and Holt; doi: 10.5694/mja17.01145
Global warming has consequences for our health, and the impact will only be exacerbated by inaction … OPEN ACCESS until 23 April

16 April Research: Damp housing, gas stoves, and the burden of childhood asthma in Australia
Knibbs et al; doi: 10.5694/mja17.00469
Exposure to damp housing and gas stoves is common in Australia, and is associated with a considerable proportion of the childhood asthma burden … OPEN ACCESS permanently

16 April Podcast with Dr Luke Knibbs, senior lecturer in Environmental Health at the University of Queensland’s School of Public Health … OPEN ACCESS permanently

16 April Research: Rheumatic heart disease in Timor-Leste school students: an echocardiography-based prevalence study
Davis et al; doi: 10.5694/mja17.00666
The rates of rheumatic heart disease in Timor-Leste are among the highest in the world, and prevalence is higher among girls than boys … OPEN ACCESS permanently

16 April Research letter: Health burden associated with fire smoke in Sydney, 2001–2013
Horsley et al; doi: 10.5694/mja18.00032
A substantial additional health burden is associated with the indirect effects of smoke from bushfires and hazard reduction burns … OPEN ACCESS permanently

16 April Narrative review: Tick-induced allergies: mammalian meat allergy and tick anaphylaxis
van Nunen; doi: 10.5694/mja17.00591
Tick-induced allergies comprise large local reactions to tick bites, mammalian meat allergy after tick bites, and tick anaphylaxis … OPEN ACCESS until 23 April

16 April Podcast with Associate Professor Sheryl van Nunen, director of the Tick-induced Allergies Research and Awareness Centre … OPEN ACCESS permanently


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One thought on “Research news and what’s new online at the MJA

  1. Anonymous says:

    “By 2015, mental disorders had reached second place as causes of DALYs in the Americas and Europe.”
    Here is a question for the masses: why is this? How about some research on that!

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